Koala Klean Hand Hygiene

Heading into my second to last semester of school I signed up for Healthcare Design of the Future. The premise was to form multidisciplinary teams to tackle a problem space in the healthcare industry. We also partnered with Children's Healthcare of Atlanta (CHOA) (and specifically the Cardiac ICU) to give us a real world client. The class started by researching the history of the Intensive Care Unit, followed by forming our teams, and then wrote a paper on our team topic.

Hand Hygiene was an interesting space for us to pick, and it certainly proved to be challenging. As you can imagine, I found in my research that compliance has been a problem in the industry as long as it has been tracked, and many solutions have been tried. One interesting piece of research was that compliance education (for nurses) had no long term effect on compliance, despite that being the default choice many hospitals pick to combat compliance dips.

The Stumble

Unfortunately we had to go through a lengthy process before we were allowed to go to the hospital itself. The certification process was going to take over a month, so our team started brainstorming solutions without the opportunity to complete user research. By the time we were able to talk to CHOA employees, we had started down the path of designing a compliance monitoring system that would detect when employees were supposed to cleaning their hands, and alert them if they did not. Our goal was a sort of Fitbit style tracker that instead of reminding you to move would remind you to wash your hands at the right moment.

We finally were able to meet with CHOA representatives, and we hit a brick wall. They weren't interested in an expensive monitoring system at all! In fact, they weren't even interested in improving their compliance monitoring either. They wanted compliance itself to show improvement. We were back to square one.

The good news was the finally could do user research and interviews! Taking shifts, we observed the Cardiac ICU as nurses completed their tasks, and as nurses went off shifts, pulled them aside to get a quick interview. With that we had a much clearer picture of the issues they faced. The key issue we teased from our user research was one of accessibility. Much of the rest of the hospital has a more traditional setup with a room for each patient and hand hygiene stations outside and inside each room. The Cardiac ICU is set up as an "open bay" meaning it is just a series of beds separated only by hanging curtains and hygiene stations are on the outside edges of the room.

The Solution

Given this new situation, we went back to brainstorming. After several rounds we whittled down to a new idea. What if nurses had access to hand hygiene devices from their computer carts? The carts are glued to their side as they chart patients' progress. We took this idea to CHOA to get feedback and they loved it. Their main question for us was when can they buy them. Encouraged by this, we went through several physical prototypes, using cardboard models and finally 3D printing.

We received positive feedback at our research showcase at the end of the semester. The most frequent comment was "I can't believe this idea is so simple, but it works!" That was a key learning point for me from this project. A simple idea with strong execution can be more impactful than a complex and costly technical idea. Keeping your eyes open to the true problem can lead to a radically different solution.